Omalizumab was approved for the treatment of refractory chronic urticaria and angioedema (CUA) since 2014. The exact mechanism of how omalizumab works in CUA has not been fully elucidated. Short-term efficacy of omalizumab for patients with refractory CUA has been shown in a number of randomized trails. However the duration of the therapy and the long term efficacy remains unclear.
Analyzing a total 90 objects with refractory CUA at our center received omalizumab 300mg every 2-6 weeks between 2013 and 2016. Stratifying the factors affecting the long term outcome of Omalizumab therapy for refractory CUA.
Among the 90 patients, 59 (65.56%) failed Cyclosporine, 20 (22.22%) failed Dapsone and 16 (17.78%) failed Hydroxychloroquine therapy in addition to antihistamine therapy. 14 (15.56%) didn’t experience significant clinical improvement after receiving at least 3 treatments. 3 (3.33%) experienced worsening symptoms and stopped the treatment. By completing at least 12 month treatment, 29 (32.22%) were able to discontinue Omalizumab. However, of the 29 patients, 18 experienced flare of urticaria and/or angioedema symptoms after discontinuing Omalizumab, ranging from 6 weeks to 36 weeks. Only 8 (8.89%) remain in complete remission more than 12 month without requiring maintenance treatment.
Omalizumab is an effective therapy for patients with refractory CUA who failed other conventional therapy. A majority of patients has to continue the treatment in order to maintain remission.